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Number of consumers enrolled in health savings accounts, high deductible plans, jumps 8%

Proposed legislation would allow pre-deductible coverage at onsite and retail clinics for treatment of primary, chronic and preventative care.

Susan Morse, Senior Editor

The number of consumers who have chosen a health savings account and a high deductible plan increased by 8 percent between 2016 and 2017, according to a new survey from America's Health Insurance Plans.

As of January 2017, 52 providers reported 21.8 million HSA and high deductible plan enrollees, an 8 percent increase from the 20.2 million in 2016.

[Also: Walmart signals continued interest in healthcare space through remodel of pharmacies]

The 45 plans participating in both the 2016 and 2017 surveys saw a 9.2 percent increase in their HSA and high deductible enrollment, AHIP said.

HSAs allow consumers to put pre-tax-dollars into a personal savings account. They are being promoted as a way for patients to take charge of their out-of-pocket costs for care.

In early March, Republican Rep. Mike Kelly of Pennsylvania and several co-sponsors introduced HR 5138, the Bipartisan HSA Improvement Act of 2018. The bill did not make it into the omnibus spending package.

One of its main premises would be to allow pre-deductible coverage at onsite and retail clinics for treatment of primary, chronic and preventative care.

This would include retail based clinics, such as CVS and Walmart clinics. Walmart has also announced plans to add private consultation rooms to its pharmacies.

It would also increase contribution limits and permit HSA funds to be used for wellness benefits, telehealth services and for over-the-counter medications without a prescription.

Opponents say retail clinics would become profit centers at the expense of better care through primary care physicians, according to Niran Al-Agba, MD, in The Health Care Blog.

A Chronic Disease Management Act currently before Congress  would allow insurers the flexibility to cover care for many chronic conditions before a patient reaches his or her deductible. Such care could include asthma inhalers, insulin, antidepressants and/or mental health treatment.

Presently, an enrollee in an HSA-qualified plan must meet his or her full deductible before the plan can pay for most services, treatments, or medications, AHIP said. 

Additional policy actions should be taken to better meet consumer needs, said AHIP, which supports the Chronic Disease Management Act, and the Bipartisan HSA Improvements Act.

"Recognizing that preventive treatment is critical to improving health outcomes and avoiding costly long-term complications, Congress allowed for preventive care to be covered pre-deductible," the insurance organization said. "There is a similar recognition that ensuring consistent access to treatment for those with chronic conditions such as diabetes, heart disease, and substance abuse disorder can help prevent expensive, debilitating complications. 

The AHIP survey is based on responses from both member and non-member plans.

Additional findings show that 85 percent of health insurance providers offer tools to help members manage their health and finances, including online access to account information, health and wellness resources, and cost and quality data.

"The increase in popularity of these plans tells an important story about consumer-centric care," said Jeanette Thornton, AHIP senior vice president of Product, Employer, and Commercial Policy. "More than ever, patients want value from their coverage, choice in their health services, and control of dollars they spend on care."

Twitter: @SusanJMorse
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